Collaborative Approach to Prevent Leprosy and HIV Coinfection in Abia, Ebonyi and Oyo States of Nigeria - Best Practices for a Healthier Population

The human immunodeficiency virus (HIV) pandemic has disproportionately affected many developing countries including Nigeria especially where dermatoses like leprosy is endemic. Though leprosy is an infectious disease, the risk of developing it is low. It is estimated that about 16,000 people are infected with leprosy annually. Early in the HIV epidemic, researchers feared that HIV infection would threaten leprosy control programmes, as have occurred with tuberculosis. It was suspected that patients with leprosy and HIV infection would have increased risk of lepromatous disease as well as clinical advancement. Moreover, that treatment for leprosy with HIV coinfection would be very difficult. Incidentally, reports on these concerns are to the contrary unlike what was noted with HIV and tuberculosis interaction. This paper, which will be organized in four sections, describes the various public health disease control programmes for leprosy and HIV infections in Nigeria. It details interaction between leprosy and HIV infection by evaluating and presenting the current situations. The paper will review the risks patients with leprosy and HIV coinfection face in clinical evolution, and likely difficulties encountered during treatment. Strengths and weaknesses in the entire programmes will be emphasized. The potent effects of leprosy and HIV infections on the human immune system, and the dearth of current information on the prevalence of co-infected patients make this area of investigation necessary. The review of the epidemiological, clinical, and pathological data relating to leprosy and HIV coinfection will provide information on the interaction between leprosy and HIV in developing countries. This will give insight to the problem by providing proper understanding of the classification system of the interaction which includes (1) leprosy and HIV true coinfection, (2) opportunistic leprosy disease, and (3) leprosy related to highly active antiretroviral therapy. Therefore, research on clinical, and management aspects of this coinfection is reviewed.